Miteku Tezera Desalgne (NPI# 1164028296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1164028296 |
| Entity Type | Individual |
| Full Name | Miteku Tezera Desalgne |
| Credential | NP |
| Gender | Male |
| Practice Address |
1412 W Sherwin Ave Unit B Chicago IL 60626-2294 |
| Practice Telephone | 7736539790 |
| Mailing Address |
1412 W Sherwin Ave Unit B Chicago IL 60626-2294 |
| Mailing Telephone | 7736539790 |
| Sole Proprietor | Yes, this individual is a Sole Proprietor |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 363LF0000X | Nurse Practitioner · Family | Physician Assistants & Advanced Practice Nursing Providers | 209022406 | IL |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come… |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265036164 | Debbie Chagoya | Nurse Practitioner | 5133 W Wilson Ave, Chicago, IL 60630-3905 | 2020-11-23 |
| 1003418138 | Megan Deedrich | Nurse Practitioner | 849 N Franklin St Unit 511, Chicago, IL 60610-8474 | 2020-11-13 |
| 1609478908 | Haley Decero | Nurse Practitioner | 2354 W George St, Chicago, IL 60618-7942 | 2020-11-11 |
| 1053913566 | Natalija Tosanic | Nurse Practitioner | 5010 N Mango Ave, Chicago, IL 60630-4609 | 2020-11-10 |
| 1649872367 | Habtamu Tamiru Abebe | Nurse Practitioner | 1337 W Fargo Ave Apt 401, Chicago, IL 60626-1854 | 2020-11-09 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| Find all providers in CHICAGO | ||||
| Street Address |
1412 W SHERWIN AVE UNIT B |
| City | CHICAGO |
| State | IL |
| Zip Code | 60626-2294 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972116390 | Rebecca Powers | Physical Therapist | 1214 West Loyola Court, Chicago, IL 60626 | 2020-08-25 |
| 1699307918 | Trilogy, Inc. | Clinic/Center | 1763 W. Estes Avenue, Chicago, IL 60626 | 2020-02-05 |
| 1134617236 | Trilogy Inc. | Clinic/Center | 7474 N Paulina St, Chicago, IL 60626 | 2018-04-25 |
| 1891203477 | Natalie Cerda | Specialist/Technologist | 6526 North Winthrop, Chicago, IL 60626 | 2018-01-17 |
| 1841709136 | Jennifer Browse | Speech-Language Pathologist | 7101 N. Greenview, Chicago, IL 60626 | 2017-09-29 |
| 1922526292 | Bill Johnson | Psychologist | 1712 W Estes Avenue Unit 109, Chicago, IL 60626 | 2017-09-06 |
| 1326580333 | Zackary Charles Davis | Specialist/Technologist | 6526 N. Winthrop Avenue, Chicago, IL 60626 | 2016-11-08 |
| 1053772913 | Devon Migues | Counselor | 6710 N Hermitage Ave, 1, Chicago, IL 60626 | 2016-03-18 |
| 1457718124 | Carol L. Marshall | Social Worker | 7231 1/2 N. Sheridan Rd, Chicago, IL 60626 | 2016-01-26 |
| 1972948206 | Donna Darcell Smith | Counselor | 1401 West Jarvis Ave., #2e, Chicago, IL 60626 | 2013-04-30 |
| Find all providers in zip 60626 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.